Resident QI Corner – Winter ’19

Managing discharge from Inpatient Heme/Onc Service

The inpatient Hematology/Oncology team at BMC is a busy service full of patients with complex medical problems and diverse pathologies requiring intricate care plans. Thus, discharges from the Heme/Onc inpatient service are complicated and are often derailed by unforeseen variables.

We sought to increase the safety and timeliness of discharges by implementing a standardized approach to discharge planning starting on the day of admission. We designed a discharge time-out checklist for the Heme/Onc team.   The team can run the checklist prior to a patient being discharged to ensure all important aspects are addressed. A Heme/Onc Bundle was also created to be used with each daily note to keep up to date on discharge planning.

We implemented the checklists as SmartPhrases from November 2017 to February 2018 and compared to pre-intervention data over the same months from 2016- 2017. After our intervention implementation, discharge time of day on the service improved by 13 minutes and time of discharge order placement  improved by 39 minutes. On average, the Heme/Onc bundle was used in 86% of notes. Future directions include use of a standardized discharge summary template for the Heme/Onc service to help facilitate safe transitions of care.

By  Rani Chudasama, MD and Matt Strickland, MD

                              

IHI Conference 2018 – Dec 9 – 12 

Quality Improvement Patient Safety (QIPS) pathway IM residents attending IHI 2018 National Forum:

Swetha Ramachandran, MD  – Improving Inter-Hospital Transfers Through Implementation of a Transfer Accept Note

 

 

Calan Sowa , MD & Ruchika Sangani, MD – Improving Primary Care Follow-Up through In-Person, In-Hospital Appointment Negotiation

 

 

Nancy Desai, MD – Cervical Cancer Screening and Prevention in Patients with Systemic Lupus Erythematosus

 

 

Kristin Hlebowitsh , MD – Minimizing Isolation: Re-screening inpatients for MRSA infection

 

 

Vishal Gupta , MD- Where Are the Blood Cultures that I Ordered?

 

 

 

Kris Clark, MD and Shaleen Chakyayil , MD – EMR-Based Intervention to Improve Venous Thromboembolism (VTE) Risk Assessment and Prescribing Practices

 

 

Other QIPS residents in attendance:
Mangwe Sabtala, MD
Prianka Ballal, MD
Laura Chiu, MD
Olivia Rowse, MD

For those of us attending for the first time, we got our batteries charged! We look forward to continuing to bring positive change to our patients and to our community.